CPT® Code 34451

Thrombectomy is a surgical procedure aimed at removing a thrombus, or blood clot, from specific veins in the body, particularly the vena cava, iliac vein, or femoropopliteal vein. This procedure can be performed directly or with the assistance of a catheter, depending on the location and nature of the thrombus. The procedure typically involves making incisions in the abdomen and/or leg to access the affected vein. A thrombus often forms in areas where the vein is narrowed or stenotic, which can impede blood flow and lead to complications. During the thrombectomy, the surgeon makes an incision in the abdomen and/or leg or groin to expose the vein and access the planned venotomy site. To control blood flow during the procedure, vessel loops are placed both proximal and distal to the thrombus. The vein is then incised, allowing for direct removal of the thrombus through the incision. Alternatively, if a catheter is used, a balloon catheter may be inserted through a venotomy at a site beyond the thrombus. This catheter is passed beyond the clot, inflated, and then withdrawn, effectively capturing and removing the thrombus. After the thrombus is removed, a venography may be performed to confirm that the entire clot has been successfully extracted and that the vein is patent, meaning it is open and unobstructed. It is important to note that specific CPT codes are designated for different approaches to thrombectomy, such as using an abdominal incision alone or a leg incision alone, with CPT® Code 34451 specifically indicating the use of both abdominal and leg incisions for the procedure.